Healthcare Provider Details

I. General information

NPI: 1538444799
Provider Name (Legal Business Name): NATALIE NELSON O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 HAYWOOD RD
GREENVILLE SC
29607-2744
US

IV. Provider business mailing address

617 HAYWOOD RD
GREENVILLE SC
29607-2744
US

V. Phone/Fax

Practice location:
  • Phone: 864-627-9500
  • Fax: 864-627-9325
Mailing address:
  • Phone: 864-627-9500
  • Fax: 864-627-9325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3887
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT002799
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.0003859
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1681
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1987-933AT
License Number StateLA
# 6
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT002662
License Number StateAZ
# 7
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number424T
License Number StateWY
# 8
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC6436
License Number StateFL
# 9
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT-2025-0023
License Number StateNM
# 10
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberODP-100456
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: